Breast milk oversupply: Blessing or a burden?

Breast milk oversupply is often described as hyperlactation or a mother 'having too much milk,' 'fast flow' or even 'overactive let down.'

Let’s set the record straight. If you’ve clicked on this link then there are two things that have happened. One, your curiosity about the phenomenon of breast milk oversupply brought you here. And two, you are going through the same problem and need to understand it better.

Either way, you have come to the right place.

Breast milk oversupply: Everything you should know

While you may have heard many new mothers complain of low milk supply, there is also such a thing as breast milk oversupply. It is often described as hyperlactation or a mother ‘having too much milk,’ ‘fast flow’ or even ‘overactive let down.’

On one hand this can be beneficial for a baby because she can gain weight easily and remain well-nourished. On the other, some babies might struggle to cope with the milk flow and volume. They may become fussy, cry, and come off the breast as milk spurts everywhere.

In some cases, it may even lead to babies spitting the milk out or as it is commonly called reflux, lactose overload or colic.

As for mothers, an overflow of breast milk can lead to engorgement, plugged ducts and even mastitis. It could also be painful because the let down is forceful and fast. These are initial signs that indicate that you might have too much milk.

All of this should not discourage you from continuing to nurse your baby. Instead, you should try to understand the causes of breast milk oversupply, recognise its signs, and learn new ways to manage it and how to continue breastfeeding with it.

What causes breast milk oversupply?

Breast milk oversupply shouldn’t worry you too much unless it becomes completely unmanageable for your baby as well as for you. Most of the time, it boils down to how you sync your feeds with your baby’s demands.

If you have already synced your feeds and you are still producing more milk than needed, then first understand why this may be happening.

Foremilk/hindmilk imbalance: One of the biggest reasons you have excess milk is because there is an imbalance between the intake of foremilk (the thin, sweet milk rich in lactose that comes at the beginning) and hindmilk (the fat-rich, high-calorie, thick milk that comes at the end of the feed). Let’s assume that an ‘average’ mother produces half an ounce of foremilk and two ounces of hindmilk. So her baby on an average will get 5 ounces (if he nurses from both breasts). But a hyperlactating mum can produce one ounce of foremilk and three of hindmilk. So in this case, the baby will get four ounces from one breast. By the time you switch him to the other breast he will be so full, that he’ll only consume a bit of foremilk (from the second breast). This will lead to an imbalance in his body because foremilk is high in lactose, he may become gassy and spit up. And because he isn’t getting much hindmilk, he may feel empty and hungry more often.

Excessive alveoli: While most ‘average’ mums have 100,000 to 300,000 alveoli per breast, a hyperlactating mum would have more than the average number. Alveoli are the milk producing glands in the breasts and therefore, an excessive count leads to higher milk production.

Improper latch: A baby who isn’t deeply latched on the breast may not be able to feed properly. He may also struggle to manage the fast flow of milk. So a combination of both can lead him to frequently demand more, and that will result in more production of milk.

You’re giving your body clues: Sometimes a new mum may inadvertently give her own body clues that she needs to produce more milk for her baby. For instance, she could be pumping excessively or may be taking some lactogenic herbs or galactagogue such as fenugreek, wild asparagus, fennel, alfalfa, sesame seeds, rice, oats, dil and chick peas.

Hormones and medical conditions: You may also end up overproducing breast milk if you have a hormonal imbalance or pituitary tumour or you may be on certain medications that propels your body to produce more milk than needed by your baby.

While most ‘average’ mums have 100,000 to 300,000 alveoli per breast, a hyperlactating mum would have more than the average number

In such a situation, you must first look for signs (as mentioned earlier) of breast milk oversupply.

What are the signs of breast milk oversupply?

If you are producing more milk than your baby can handle, despite having a good latch and good tongue movement, he will still exhibit signs that give away his inability to feed. Look for these signs of breast milk oversupply.

Your baby might choke, cough and even come off your breast in the middle of the feed

He may seem fussy, restless and uncomfortable

Your baby may only have short frequent feeds and stop in between

He may also try to bite your nipples or clench on to them because that’s the only way he can slow down the supply

He may spit up or have colic or become excessively gassy

His stools may become watery and his bottoms might turn slightly red and perhaps even sore

You may suffer from leaky breasts, engorgement, cracked nipples, plugged ducts and even mastitis

Will breast milk oversupply affect my baby?

The good news is that overproducing breast milk or hyperlactating means that your body is able to match your baby’s growing feed demands, and there is enough milk to keep your baby nourished and well-fed.

The bad news is that if a baby is unable to handle the excess flow of foremilk he may become colicky and fussy and even gassy. It may also interfere with his growth and development because he is unable to consume enough hindmilk and spurts out whatever he consumes in the first place.

The best thing to do in this situation is to manage the excess milk smartly.

If nothing works and you still have a lot to offer, you can always donate your breast milk

How do I manage breast milk oversupply?

You can try to manage excessive breast milk supply by trying new positions, offering single breast and limiting pumping. Here are a few things you can do at home:

Offer one breast at a time: Allow your baby to nurse on a single breast. Ideally, he should be latched on for a minimum of 15-20 minutes. If he has nursed for less time, then you should put him back on the same breast. Do this until he feeds for the complete 15-20 minutes. Do not offer the second breast after this time, unless he demands it. Remember that newborns will still ask for the second breast even if they are not hungry. That’s because they love to suckle and not necessarily because they are hungry. If your other breast gets engorged, try to pump some milk, but do not empty your breasts completely.

Alter your nursing position: Sometimes lying in positions that allow gravity to slow down your milk can also work. For instance, try lying on the bed with your baby facing the nipple. You can also lean back slightly and place your baby on top of your chest. Or you can try the football hold, placing your baby’s head above the rest of his body. This will also allow him to be more in control of the flow. Just make sure you are ready with a towel to wipe off any leakage.

Relax the letdown: Before putting him on the breast, collect the first spurts and the first forceful sprays in a bottle. Or you can wipe that off and then put the baby on the breast. If you notice your baby gagging on your milk, simply express a little and then put him back. All these techniques will ensure that he is feeding on normal flow. Follow this up with burping your baby to help him digest better.

Stop expressing your milk: Do not express your milk or pump unless you have no choice. Because if you pump and empty your breasts, you will give your body signals to produce more milk. Even though this will give you temporary relief, it’s not beneficial in the long run. So express, but not all the milk; just enough to feel comfortable.

Use excess breast milk elsewhere: If nothing works and you still have a lot to offer, you can donate your breast milk. There are many human milk banks in the market now, and they cater to preemies who desperately need breast milk. So while managing your oversupply, you can help somebody else’s baby as well. Alternatively, you can prepare breast milk ice cream or use the excess milk in cereals.

If none of this works out, reach out to a lactation consultant.

Typically, the problem of breast milk oversupply gets solved when your baby matures and is able to handle the excess. By that time, your body also gets used to the amount of milk your baby demands and so both the ‘giving’ and ‘receiving’ gets synced.